218113 03/13/2013 CITY OF CARMEL, INDIANA VENDOR: 358389 Page 1 of 1
ONE CIVIC SQUARE JACK DOHENY SUPPLIES INC CHECK AMOUNT: $179.00
I to CARMEL, INDIANA 46032 PO BOX 609
NORTHVILLE MI 48167 CHECK NUMBER: 218113
CHECK DATE: 3/13/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 C45161 179 . 00 OTHER EXPENSES
& Dohepy Qj Re mittance Address:Jack Doheny Supplies, Inc. Phone (248)349-0904
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P.O. Box 609 warld s Largest Distributor q(sewer cleaning. Fax(248)349-2774
Northville, Michigan 48167 Ait-Handl,ugandStreetSweepingEquipme„t www.dohenysupplies.com
Customer I N V O I C E Invoice Pg
CARME03 C45161 1
/26/13
Sold To Ship To
CARMEL WASTEWATER TREATMENT RANDY
760 THIRD AVENUE SW CARMEL WASTEWATER TREATMENT
CARMEL IN 46032 9609 HAZEL DELL PARKWAY
INDIANAPOLIS IN 46280
317-571 -2634 317-571-2634
Ship Via WILL CALL FOB JDS WHITESTOWN IN FACILITY
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Br Trk Make Model Serial Equipment Meter Sls Customer P. O.
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007 LET TK# 80
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Ordr Ship B/0 Description List Each Amount
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Taken By BOB SMITH Opened 2/26/13
Shipped 2/26/13
1 1 V3 40052JD 179. 00 179. 00 179. 00
SWIVEL JOINT, 1
TOTAL PARTS 179. 00
INDIANA MUNICIPALITIES . 00
VISIT OUR WEBSITE @ www. dohenysupplies. com
WE APPRECIATE YOUR BUSINESS
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Total 179. 00
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SEE REVERSE SIDE FOR SALE TERMS AND CONDITIONS
SALE TERMS AND CONDITIONS
The sale terms and conditions of Jack Doheny Supplies, Inc., d/b/a Jack Doheny Companies and its affiliates ("Doheny")
which can be found at www.dohenysupplies.com (the "Doheny Sale Terms and Conditions"), are hereby
incorporated into and made a part of this invoice and shall be construed with and as an integral part of this invoice to
the same extent as if set forth verbatim herein. This invoice and the parties` entire relationship hereunder shall be
governed exclusively by the Doheny Sale Terms and Conditions.
Doheny hereby objects to and rejects any proposal for additional, different or inconsistent terms or any attempt by
-Seller to vary in any degree any of the terms of the Doheny Sale Terms and Conditions, but any such proposals shall
not operate as a rejection of this offer by you, unless such variances are in the terms of the description, quantity,
price or delivery schedule of the goods or services, and this offer shall be deemed accepted by you without said
additional, different or inconsistent terms. If this invoice shall be deemed an acceptance of a prior offer by Seller,
such acceptance is limited to the express terms set forth herein, including the Doheny Sale Terms and Conditions.
VOUCHER # 135034 WARRANT # ALLOWED
358389 IN SUM OF $
JACK DOHENY SUPPLIES INC
PO BOX 609 ,
NORTHVILLE, MICHIGAN 48167
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
C45161 01-7200-02 $179.00
ti
Voucher Total $179.00
Cost distribution ledger classification if
claim paid under vehicle highway fund
Prescribed by State Board of Accounts City Form No. 201 (Rev 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show, kind of service, where
performed, dates of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
358389
JACK DOHENY SUPPLIES INC Purchase Order No.
PO BOX 609 Terms
NORTHVILLE, MICHIGAN 48167 Due Date 3/6/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
3/6/2013 C45161 $179.00
I hereby certify that the attached invoice(s), or bill(s) is (are) true and
correct and I have audited same in accordance with IC p5-11-10-1.6
Date Officer